摘要
Theriskofbreastcancer(BC)overdiagnosisattributedtomammographyscreeningisanunresolvedissue,complicatedbyheterogeneityinthemethodologyofquantifyingitsmagnitude,andbothpoliticalandscientificelementssurroundinginterpretationoftheevidenceonthisphenomenon.EvidencefromrandomizedtrialsandalsofromobservationalstudiesshowsthatmammographyscreeningreducestheriskofBCdeath;similarly,thesestudiesprovidesufficientevidencethatoverdiagnosisrepresentsaseriousharmfrompopulationbreastscreening.Forboththeseoutcomesofscreening,BCmortalityreductionandoverdiagnosis,estimatesofmagnitudevarybetweenstudieshoweveroverdiagnosisestimatesareassociatedwithsubstantialuncertainty.Thetrade-offbetweenthebenefitandthecollectiveharmsofBCscreening,includingfalse-positivesandoverdiagnosis,ismorefinelybalancedthaninitiallyrecognized,howeverthesnapshotofevidencepresentedonoverdiagnosisdoesnotmeanthatbreastscreeningisworthless.Futureeffortsshouldbedirectedtowards(a)ensuringthatanychangesintheimplementationofBCscreeningoptimizethebalancebetweenbenefitandharms,includingassessinghowplannedoractualchangesmodifytheriskofoverdiagnosis;(b)informingwomenofalltheoutcomesthatmayaffectthemwhentheyparticipateinscreeningusingwell-craftedandbalancedinformation;and(c)investinginresearchthatwillhelpdefineandreducetheensuingovertreatmentofscreen-detectedBC.
出版日期
2017年01月11日（中国期刊网平台首次上网日期，不代表论文的发表时间）
